Provider Demographics
NPI:1245673011
Name:DEPENDABLE LAB SERVICES INC
Entity type:Organization
Organization Name:DEPENDABLE LAB SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DETAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-864-5017
Mailing Address - Street 1:PO BOX 340
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-0340
Mailing Address - Country:US
Mailing Address - Phone:724-864-5017
Mailing Address - Fax:724-864-4975
Practice Address - Street 1:114 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-3402
Practice Address - Country:US
Practice Address - Phone:724-864-5017
Practice Address - Fax:724-864-4975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory